Department of Surgical Oncology, Claudius Regaud Cancer Center, 20-24 Rue Pont-Saint-Pierre, Toulouse, France.
Gynecol Oncol. 2010 Aug 1;118(2):145-50. doi: 10.1016/j.ygyno.2010.03.011. Epub 2010 May 7.
To estimate the incidence of clinically detected port-site metastases (PSM) in patients with endometrial and cervical cancer treated at two gynecologic oncology services with extensive experience.
All eligible uterine cancer patients laparoscopically staged at Centre Oscar Lambret in Lille and Institut Claudius Regaud in Toulouse, France, were reviewed. MEDLINE database was searched to identify articles on PSM after laparoscopic procedures for cervical and endometrial cancer.
During the study period, 1216 laparoscopic procedures for uterine cancer were performed. 921 patients underwent laparoscopic staging for cervical cancer and 295 for endometrial cancer. The overall incidence of PSM in our institutions was 0.4% per procedure (5 patients), and the incidence of PSM after laparoscopy for cervical and endometrial cancer was 0.43% and 0.33%, respectively. Excluding patients with peritoneal carcinomatosis, the rate of port-site recurrence in our series lowered to 0.16%, and the rate of isolated PSM to 0%. The median time to the development of PSM was 8 months (range 6-48), the median overall survival from diagnosis for all patients was 26 months (range 7-30), and median survival from recurrence was 5 months (range 1-20).
Although PSM is recognized as a complication of laparoscopy for ovarian cancer. PSM is a rare complication of laparoscopic staging for endometrial and cervical cancer. The majority of patients with PSM presented with associated synchronous disease. The incidence of isolated PSM can be maintained virtually to 0% by an adequate operative technique. We believe that PSM in patients with uterine cancer cannot be used as an argument against laparoscopic staging in uterine cancer.
评估在两家妇科肿瘤中心接受广泛腹腔镜分期手术的子宫内膜癌和宫颈癌患者中临床检测到的种植转移（port-site metastases，PSM）的发生率。
回顾性分析在法国里尔奥斯卡·朗布雷特中心（Centre Oscar Lambret）和图卢兹克劳德·雷高德研究所（Institut Claudius Regaud）接受腹腔镜分期的所有符合条件的子宫癌患者。检索 MEDLINE 数据库，以确定腹腔镜治疗宫颈癌和子宫内膜癌后 PSM 的文章。
研究期间，共进行了 1216 例腹腔镜子宫癌手术。921 例患者接受了宫颈癌腹腔镜分期，295 例患者接受了子宫内膜癌腹腔镜分期。本机构的总体 PSM 发生率为每例手术 0.4%（5 例），宫颈癌和子宫内膜癌腹腔镜手术后 PSM 的发生率分别为 0.43%和 0.33%。排除腹膜转移患者后，本系列的 PSM 复发率降至 0.16%，孤立性 PSM 率降至 0%。PSM 的中位发生时间为 8 个月（6-48 个月），所有患者的中位总生存期为 26 个月（7-30 个月），中位复发后生存期为 5 个月（1-20 个月）。
尽管 PSM 被认为是卵巢癌腹腔镜手术的并发症，但 PSM 是子宫内膜癌和宫颈癌腹腔镜分期的罕见并发症。大多数 PSM 患者均伴有同步疾病。通过适当的手术技术，孤立性 PSM 的发生率几乎可以保持为 0%。我们认为，子宫癌患者的 PSM 不能作为反对子宫癌腹腔镜分期的理由。
